Bellin-ThedaCare Healthcare Partners Selected for National Medicare Pilot Program

December 19, 2011

Healthcare Providers Team Up to Provide High-Quality, Low-Cost Care

Bellin Health, ThedaCare and a network of nearly 700 physicians are participating in an innovative Medicare pilot payment program designed to improve healthcare services for patients in Northeast Wisconsin.

“The Center for Medicare Services’ (CMS) Innovation Center’s decision to pick Bellin Health-ThedaCare Healthcare Partners as part of its Pioneer Accountable Care Organization (ACO) model is a notable achievement since only 32 organizations nationwide were chosen to participate,” said Dave Krueger, MD, medical director for Bellin Health-ThedaCare Healthcare Partners.

ACOs were part of the Patient Protection & Affordable Care Act, which encouraged their formation as a way to improve the quality of healthcare while slowing the growth of costs. By organizing healthcare teams, technology and knowledge around patient needs, the expectation is that ACOs can achieve better care for Medicare beneficiaries while slowing cost increases.

“The Pioneer ACOs represent our nation’s leaders in health systems innovation, providing highly coordinated care for patients at lower costs,” said Marilyn Tavenner, Acting Administrator of CMS. “Bellin Health-ThedaCare Healthcare Partners has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them,”

“We have a strong history of providing high-quality medical care while also holding down costs. Our collective work is often recognized throughout the country and being chosen to participate in this pilot program is a testament to the quality of care we provide to patients,” Dr. Krueger said. “The goals of the Pioneer ACO are to improve patient care and control the per capita cost of healthcare. To achieve those goals, the doctors and medical staff will need to work together to develop the right tools, personnel, and management competencies across each individual patient’s care needs.”

The ACO model defines a group of individuals – in this case, Medicare patients whose providers have an affiliation with Bellin Health-ThedaCare Healthcare Partners – and part of the payment to the healthcare organization is based on achievement of specific goals including process measures, clinical outcomes and patient satisfaction scores.

The model is designed to work in coordination with private insurance companies and employers with the goal of saving money while improving care quality and outcomes. Since Medicare is the nation’s largest payer of healthcare costs, any changes they make will dramatically impact how healthcare is delivered.

“This is a wonderful opportunity for ThedaCare, Bellin and independent physicians to help transform the future of healthcare,” said Dean Gruner, MD, president and CEO of ThedaCare. “We know there are many problems today with healthcare in the United States. By making this decision, we are choosing to be a part of the solution, and not part of the problem. We will have the opportunity to work closely with other thought leaders in shaping how to improve the quality of healthcare in this country while also bending the cost of care.”

George Kerwin, Bellin Health president and CEO, says the pilot project seeks to reward medical systems for providing quality, low-cost care to patients. “Both individually and in collaboration, the physicians and health systems have long maintained our emphasis on quality initiatives as a way to help control costs for healthcare consumers,” Kerwin said. “This new era in healthcare and participation in the ACO is the continuation and evolution of us working together as partners across our hospitals, primary care clinics and specialty clinics to improve medical care for our patients.”

Bellin Health and ThedaCare have a history of working together. They, along with select independent physicians, launched Touchpoint Health Plan in the 1990s. When the health plan was sold, they continued improving healthcare together through the Northeast Wisconsin Health Value Network (NEWHVN). NEWHVN was formed in 2008, bringing together two healthcare systems and independent physicians with the goal of creating value through quality improvement and the efficiency of care provided. The organization recently renamed itself Bellin Health-ThedaCare Healthcare Partners to better represent the parties involved. Bellin Health-ThedaCare Healthcare Partners covers 12 counties in Northeast Wisconsin. Two major healthcare systems: Bellin Health, based in Green Bay, and ThedaCare, based in Appleton, as well as eight major healthcare facilities, and nearly 700 physicians, make up the network.

About Bellin Health

Bellin Health, www.bellin.org, is an integrated health care delivery system based in Green Bay. It has serviced people in Northeast Wisconsin and Michigan’s Upper Peninsula since 1908. It is comprised of Bellin Hospital, Bellin Psychiatric Center, 26 Bellin Health Family Medical Center primary care physician clinics, and several retail health clinics known as Bellin Health FastCare. Bellin also operates Bellin Health Partners, a physician-hospital organization with more than 200 specialty physician members, the Oconto Hospital & Medical Center, a critical care access hospital in Oconto, Bellin Fitness Center with four locations, and Bellin College. With its 3,080 employees, Bellin Health is known for its emphasis on preventive health care and is the region’s leader in cardiac, orthopedics, sports medicine, digestive health, mental health, and primary care medicine.

About ThedaCare

ThedaCare™ is a community health system consisting of five hospitals: Appleton Medical Center, Theda Clark Medical Center, New London Family Medical Center, Shawano Medical Center, and Riverside Medical Center in Waupaca. ThedaCare also includes ThedaCare Physicians, ThedaCare Behavioral Health, ThedaCare At Work and ThedaCare at Home. ThedaCare is the largest employer in Northeast Wisconsin with more than 6,175 employees. Follow ThedaCare on Facebook and Twitter.

For more information, media may contact Dana Bzdawka (debzda@bellin.org), team leader for public relations and communication for Bellin Health, at (920) 433-7811 or Megan Wilcox, APR, (megan.wilcox@thedacare.org), public relations and corporate specialist for ThedaCare, at (920) 830-5847, or call the Theda Clark Medical Center switchboard at (920) 729-3100 and ask for the marketing person on call.